Intrasellar latrogenic carotid pseudoaneurysm: endovascular treatment with a polytetrafluoroethylene-covered stent

Cardiovasc Intervent Radiol. 2003 May-Jun;26(3):298-301. doi: 10.1007/s00270-003-2728-4.

Abstract

This case illustrates successful treatment of a large postoperative intrasellar pseudoaneurysm with a polytetrafluoroethylene (PTFE)-covered stent. The advantages and potential disadvantages of this novel method of treatment are discussed. A previously healthy 59-year-old man underwent transsphenoidal operative treatment for hypophyseal macroadenoma, complicated by bleeding. On the 17th postoperative day the patient had profuse arterial bleeding from his nose requiring posterior tamponade. Subsequent angiography of the left internal carotid artery (ICA) revealed a large pseudoaneurysm located intrasellarly, with the orifice in the anteromedial wall in the ophthalmic segment of the ICA. Surgical treatment of the pseudoaneurysm was considered very risky. A 12-mm PTFE-covered stent (JoMed, Ulestraten, Netherlands), manually compressed on a PTCA-balloon (Maxxum 4.5/13 mm, Boston Scientific, Ireland) was endovascularly delivered covering the orifice of the pseudoaneurysm. Control angiography immediately after the intervention and one year later revealed no flow into the pseudoaneurysm and the ICA was fully patent. In conclusion, deployment of a PTFE-covered stent proved to be feasible and successful in the treatment of an intrasellar iatrogenic ICA pseudoaneurysm. Adequate anticoagulative treatment after the procedure is essential to prevent thrombotic complications.

Publication types

  • Case Reports

MeSH terms

  • Blood Vessel Prosthesis
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / pathology
  • Carotid Artery, Internal / surgery
  • Carotid-Cavernous Sinus Fistula / surgery*
  • Coated Materials, Biocompatible / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Polytetrafluoroethylene / therapeutic use
  • Sella Turcica / blood supply*
  • Sella Turcica / diagnostic imaging
  • Sella Turcica / surgery*
  • Stents
  • Tomography, X-Ray Computed

Substances

  • Coated Materials, Biocompatible
  • Polytetrafluoroethylene